Challenges to the Standardization of Trauma Data Collection in Burn, Traumatic Brain Injury, Spinal Cord Injury, and Other Trauma Populations: A Call for Common Data Elements for Acute and Longitudinal Trauma Databases

Published:October 26, 2018DOI:



      Common data elements (CDEs) promote data sharing, standardization, and uniform data collection, which facilitate meta-analyses and comparisons of studies. Currently, there is no set of CDEs for all trauma populations, but their creation would allow researchers to leverage existing databases to maximize research on trauma outcomes. The purpose of this study is to assess the extent of common data collection among 5 trauma databases.


      The data dictionaries of 5 trauma databases were examined to determine the extent of common data collection. Databases included 2 acute care databases (American Burn Association’s National Burn Data Standard and American College of Surgeons’ National Trauma Data Standard) and 3 longitudinal trauma databases (Burn, Traumatic Brain Injury, Spinal Cord Injury Model System National Databases). Data elements and data values were compared across the databases. Quantitative and qualitative variations in the data were identified to highlight meaningful differences between datasets.







      Main Outcome Measures



      Of the 30 data elements examined, 14 (47%) were present in all 5 databases. Another 9 (30%) elements were present in 4 of the 5 databases. The number of elements present in each database ranged from 23 (77%) to 26 (86%). There were inconsistencies in the data values across the databases. Twelve of the 14 data elements present in all 5 databases exhibited differences in data values.


      This study demonstrates inconsistencies in the documentation of data elements in 5 common trauma databases. These discrepancies are a barrier to database harmonization and to maximizing the use of these databases through linking, pooling, and comparing data. A collaborative effort is required to develop a standardized set of elements for trauma research.


      List of abbreviations:

      BMS (Burn Model System), CDE (common data element), NBDS (National Burn Data Standard), NIDILRR (National Institute on Disability, Independent Living, and Rehabilitation Research), NINDS (National Institute of Neurological Disorders and Stroke), NTDS (National Trauma Data Standard), PRO (patient-reported outcome), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model System), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model System)
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        • The American Association for the Surgery of Trauma
        Trauma facts.
        (Available at:) (Accessed August 22, 2017)
        • World Health Organization, The World Bank
        World report on disability.
        (Available at:) (Accessed August 22, 2017)
        • Centers for Disease Control and Prevention
        Estimated lifetime medical and work-loss costs of emergency department-treated nonfatal injuries—United States, 2013.
        MMWR Morb Mortal Wkly Rep. 2015; 64: 1078-1082
        • National Academies of Sciences Engineering and Medicine
        A National Trauma Care System: integrating military and civilian trauma systems to achieve zero preventable deaths after injury.
        (Available at:) (Accessed August 24, 2017)
        • NINDS
        NINDS common data elements.
        (Available at:) (Accessed December 14, 2017)
        • Corwin E.J.
        • Moore S.M.
        • Plotsky A.
        • et al.
        Feasibility of combining common data elements across studies to test a hypothesis.
        J Nurs Scholarsh. 2017; 49: 249-258
        • NIH: US National Library of Medicine
        Common data element (CDE) resource portal.
        (Available at:) (Accessed August 25, 2017)
        • Sheehan J.
        • Hirschfeld S.
        • Foster E.
        • et al.
        Improving the value of clinical research through the use of common data elements.
        Clin Trials. 2016; 13: 671-676
        • U.S. Food & Drug Administration
        Study data standards: what you need to know.
        (Available at:) (Accessed August 25, 2017)
        • CDISC
        What we do.
        (Available at:) (Published 2018. Accessed January 10, 2018)
        • Hume S.
        • Aerts J.
        • Sarnikar S.
        • Huser V.
        Current applications and future directions for the CDISC operational data model standard: a methodological review.
        J Biomed Inform. 2016; 60: 352-362
        • Ohmann C.
        • Banzi R.
        • Canham S.
        • et al.
        Sharing and reuse of individual participant data from clinical trials: principles and recommendations.
        BMJ Open. 2017; 7e018647
        • Grinnon S.T.
        • Miller K.
        • Marler J.R.
        • et al.
        National Institute of Neurological Disorders and Stroke common data element project - approach and methods.
        Clin Trials. 2012; 9: 322-329
        • Maas A.I.
        • Harrison-Felix C.L.
        • Menon D.
        • et al.
        Common data elements for traumatic brain injury: recommendations from the interagency working group on demographics and clinical assessment.
        Arch Phys Med Rehabil. 2010; 91: 1641-1649
        • Biering-Sørensen F.
        • Alai S.
        • Anderson K.
        • et al.
        Common data elements for spinal cord injury clinical research: a National Institute for Neurological Disorders and Stroke project.
        Spinal Cord. 2015; 53: 265-277
        • Schneider J.C.
        • Chen L.
        • Simko L.C.
        • et al.
        Challenges to the standardization of burn data collection: a call for common data elements for burn care.
        J Burn Care Res. 2017;
        • American College of Surgeons
        About ACS NSQIP.
        (Available at:) (Accessed August 22, 2017)
        • American College of Surgeons
        Trauma Quality Improvement Program.
        (Available at:) (Accessed August 22, 2017)
        • American Burn Association
        Registry programs.
        (Available at:) (Accessed August 22, 2017)
        • Lavallee D.C.
        • Chenok K.E.
        • Love R.M.
        • et al.
        Incorporating patient-reported outcomes into health care to engage patients and enhance care.
        Health Aff (Millwood). 2016; 35: 575-582
        • American College of Surgeons
        National Trauma Data Bank 2016 Annual Report.
        (Available at:) (Accessed October 6, 2017)
        • American College of Surgeons
        What is the NTDS?.
        (Available at:) (Accessed October 6, 2017)
        • National Data and Statistical Center for the Burn Model Systems
        Burn Model Systems National Longitudinal Database.
        (Available at:) (Accessed August 25, 2017)
        • Traumatic Brain Injury Model Systems National Data and Statistical Center
        Standard operating procedures.
        (Available at:) (Accessed August 25, 2017)
        • National Spinal Cord Injury Statistical Center
        National Spinal Cord Injury Model Systems (SCIMS) Database.
        (Available at:) (Accessed August 25, 2017)
        • U.S. Centers for Medicare & Medicaid Services
        The hospital value-based purchasing (VBP) program.
        (Available at:) (Accessed December 9, 2017)
      1. Cohen MZ, Thompson CB, Yates B, Zimmerman L, Pullen CH. Implementing common data elements across studies to advance research. Nurs Outlook 63:181-8.

        • Bruland P.
        • McGilchrist M.
        • Zapletal E.
        • et al.
        Common data elements for secondary use of electronic health record data for clinical trial execution and serious adverse event reporting.
        BMC Med Res Methodol. 2016; 16: 159
        • Thompson H.J.
        • Vavilala M.S.
        • Rivara F.P.
        Common data elements and federal interagency traumatic brain injury research informatics system for TBI research.
        Annu Rev Nurs Res. 2015; 33: 1-11